Hepatitis C: The Basics

Hepatitis means inflammation of the liver. It can leave the liver scarred and unable to work properly.

Hepatitis can be caused by heavy drinking, drug use, genetic diseases and viral infections. One of the viral infections that can cause this is called hepatitis C.

You may see this written as hepatitis C virus or HCV.

You'll also hear about hepatitis A, hepatitis B, and less often, hepatitis D and hepatitis E. Although they all damage the liver, each one is a totally different virus. The vaccinations you can get for hepatitis A and hepatitis B won't protect you against hepatitis C.

Look After Your Liver

The liver is the largest organ inside the body. It's essential for life. Among other things, it filters unwanted substances from blood, extracts nutrients from food and manufactures proteins and hormones. It plays a vital role in processing drugs and medicines, too.

The effects of infection with hepatitis C vary from person to person. Most people don't notice any symptoms when they first get hepatitis C. They may live with the virus for many years without realizing it. Progression to the most serious forms of liver damage is not inevitable.

But hepatitis C can make some people very seriously ill. Healthy liver tissue may start to be replaced by scar tissue, hardening the liver and interfering with its vital functions. This scarring of the liver is known as fibrosis. More serious scarring is called cirrhosis.

Left untreated, cirrhosis can lead to liver cancer (called hepatocellular carcinoma or HCC), liver failure and the need for a liver transplant.

Prevention and Testing

The hepatitis C virus is found in blood. It's spread between people when blood carrying the virus gets into the bloodstream of another person.

This most often happens when people use equipment for injecting drugs that has already been used by someone else. Transmission also happens if tattooing, piercing or medical equipment is not properly sterilized between uses. Sexual transmission is an issue for gay men living with HIV, but less so for other people.

In the past, some people got hepatitis C through blood transfusions or organ transplants. However, in the U.S., a thorough screening policy has been in place since 1992.

Around 2.7 million people have hepatitis C in the U.S., but most don't know they have it because they don't look or feel unwell. That makes testing vital for many people.

To check your status, two blood tests may be needed:

An antibody test to show if you've ever been exposed to hepatitis C.

A viral load test to show if hepatitis C is still in your body.

A Treatment Revolution

Hepatitis C can be a lifelong infection, but treatment isn't. With 12 weeks of treatment (or in some cases six), many people are able to clear the virus from their body. The new treatments are much easier and simpler to take -- and more effective -- than those used in the past.

The difficulty may be in getting your health plan or insurer to pay for the treatment. The new hepatitis C drugs are some of the most expensive medicines on the market.

The pharmaceutical companies say that the price tag is justified by the difference the treatments make to peoples' lives. Some insurers argue that's only the case for people whose liver disease is already far advanced -- that the treatments won't necessarily make such a difference to people whose liver is still in pretty good shape. Many people living with hepatitis C would just like to get rid of the virus as soon as possible, before it can cause any more damage.

The Outlook for People Living With Hepatitis C and HIV

A lot of people have both hepatitis C and HIV. This is known as coinfection. Getting hepatitis C treated is especially important for people who also have HIV, as liver disease tends to advance more quickly in people who have both viruses.

The good news is that the new, modern hepatitis C drugs work just as well in people with HIV as in HIV-negative people. (The older drugs didn't.) You can safely be treated for both infections at the same time.

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